For many years, the tummy tuck consisted of making a hip to hip scar to remove excessive skin and fat, tighten the abdominal muscles which have separated or stretched usually from pregnancy and removing the excess skin just above the pubic area level. This is a classic tummy tuck or abdominoplasty. The modern abdominoplasty done by Dr. Marosan has little resemblance to the above description. The tummy tuck or abdominoplasty is part of the 360 degrees body sculpting procedure, it is never done as a stand alone operation by Dr. Marosan. It is commonly performed on women with significant skin folds after multiple pregnancies, C-section scar, excess fat on the hips, waist, bra rolls, fat rolls under the breasts,etc. Best candidates are women with a BMI of 30 or less. Women who are obese, are not good candidates for an abdominoplasty. With advanced technology, Seattle area body sculpting plastic surgeon, Dr. Marosan, performs a short, low scar tummy tuck, along with 4D tummy tuck for superior results. Dr. Marosan, in fact, is only one of a handful of surgeons around the world who have been trained in this highly technical procedure. Not only is the appearance of scarring minimized, but a better outcome is possible with contouring the whole torso to create an hourglass figure. Dr. Marosan creates three dimensional changes as opposed to the two dimensional surgery in a standard tummy tuck. A tummy tuck is part of the 3D body sculpting procedure in Dr. Marosan's philosophy, not the main procedure as in most surgeons' philosophy.

In addition to removing the unwanted skin and fat, the 4D tummy tuck further sculpts the abdomen, while maintaining the integrity of blood vessels and nerves for safer, more reliable results. After the surgery, the abdomen is contoured with better muscle definition vs an amorphous flat abdomen, and trimmer for a look that will surely boost any patient’s confidence.

In patients who undergo a full tummy tuck, the incision varies in length, but is always placed in a low location, thus the resultant scar line can be hidden when wearing undergarments or bikini. The tummy tuck or abdominoplasty is part of the 360 degrees body sculpting procedure, it is never done as a stand alone operation by Dr.Marosan. Women who are obese, are not good candidates for an abdominoplasty. Liposuction is performed to remove excess fat preceding the skin tightening portion. The rectus abdominis muscles and sometimes the oblique muscles are sutured in two layers  for a firm, toned appearance. Dr. Marosan uses progressive tension sutures to create an athletic abdomen and decrease the risk for seroma. He might or might not use a drain, which depends on how much liposuction is done at the same time. Dr. Marosan believes that it is not enough to make the abdomen flat without muscle definition or contouring the rest of the back, waist, hips, lower back fat pad, lateral chest wall to complement and enhance the results. This gives an hourglass, athletic and youthful body all the way around. Dr. Marosan, truly will turn back the clock to a more youthful and athletic figure.

An abdominoplasty with liposuction offers plenty of cosmetic rewards. It also delivers certain medical benefits as documented in recent studies. These are: 1. Correction of ventral and/or umbilical hernia, 2. Reduce stress urinary incontinence, 3. Decrease back pain and 4. Improved core and posture.

A traditional mini tummy tuck tightens the muscle from the belly button to the pubic bone. The muscle or skin are not affected above the belly button. In my practice, less than 10% of patients are good candidates for this procedure. Patients wrongly believe that a mini will give them a mini scar. This is not true in most cases, since most surgeons apply the same technique as for a full tummy tuck. An alternative to the traditional technique is the modified mini tummy tuck, which is also known as a “Brazilian tummy tuck.” The difference is that ideally the patients that undergo this procedure are already in relatively good shape with a healthy skin tone, but still have loose skin on the lower abdomen. Unlike  the full tummy tuck, the belly button is unaffected and the incision is smaller.  VASER Hi Def Liposuction is used to remove excess fat and sculpt the abdomen, and the loose skin is removed low at the pubic bone level. With special instrumentation, Dr. Marosan tightens the abdominal muscles from the breast bone to the pubic bone, just like in a full tummy tuck. Liposuction of the waist, hips and back are done routinely to give an hourglass figure. Often, a Brazilian Buttock Lift is done to complete a total transformation.

In cases when major skin tightening and body contouring is needed, an extended tummy tuck is recommended. This is a necessary technique for patients who have undergone a significant weight loss. It was developed after some patients noted that even after a full tummy tuck, the parts surrounding the abdomen still showed excessive folds of skin. The incision may extend around the flank and sides depending where skin tightening is necessary. At times, an abdominoplasty is combined with a lower body lift to reshape and tone the body. Liposuction is still used and excess skin is trimmed then tightened. Similar to a full tummy tuck, the belly button is repositioned or completely removed. Dr. Marosan creates a new belly button 2-4 weeks later with no signs of sutures.

A tummy tuck is done under intravenous sedation and tumescent anesthesia. It is an outpatient procedure done in our certified office operating suite. Intra operatively, Dr. Marosan uses Exparel, a long lasting local anesthetic, injected into the abdominal muscles for pain control. This avoids you carrying a pain pump.  As with any other surgery, abdominoplasty comes with risks so it’s best to discuss any health conditions you have prior to surgery. After surgery, pain medications are provided and a compression garment is worn. The patient will need to rest the day of surgery. From then on, it is recommended that patients make a concerted effort to move around and walk every two hours during the day to help blood circulation and reduce the risks of blood clot complications.  Initial recovery takes 7-10 days, but full recovery may take up to 6 weeks or longer.

Tummy tucks are reserved for patients who have stretched, loose skin in the lower abdomen as a result of pregnancy or obesity.  Liposuction, on the other hand, is for those who want to remove excess fat in the abdomen but still have a healthy skin tone. During the initial consultation, Dr. Marosan will provide a thorough assessment and determine if liposuction alone is all that is needed, or if a tummy tuck alone or with liposuction will provide the best results. If a person has large amounts of fat over the abdomen, Dr. Marosan prefers to do liposuction first and do the tummy tuck later for the best results. This will make your incision shorter and the abdomen will have the best possible contour.  Other surgeons might offer an abdominoplasty with liposuction of the flanks in an overweight patient. Although this can be done, it will not give you the results you were believed to expect. I know this, because I fix many of these patients from other offices.

Normally, abdominoplasty is performed to improve loose skin and excess fat around the abdominal area. With modern body sculpting techniques, superior results can be obtained over a standard tummy tuck. However, sometimes other cosmetic procedures, such as breast augmentation or a breast lift are done to further improve the overall look and feel of the body. When this combination type surgery exists, it is known as a “mommy makeover”. It is very popular among women after pregnancy who wish to get their pre-pregnancy body and shape back to normal.

Unfortunately, with a tummy tuck surgery, scars are unavoidable. However, extra measures are taken to make sure that scarring is minimal. The incision line is placed in areas that can be concealed by undergarments. Previous C-section scars will be removed, since Dr. Marosan prefers to place the tummy tuck incision lower, at the pubic bone level and one finger breadth above the groin crease. Dr. Marosan uses progressive tension sutures underneath which take the tension off the suture line itself and create a thin, flat scar. He also uses sutures to prevent the pubic hairline from migrating up into the lower abdomen. All the sutures used are disolvable with no potential suture problems in the long run. During the healing process, we will provide a post-operative protocol that includes scar with special tape support of the incision and treatment to help assist the scars in becoming less visible.  

It is our recommendation that women who decide to have more children delay a tummy tuck procedure. The stretching of the skin as a result of another pregnancy can reduce the positive outome of this procedure.